Mobile health as a viable strategy to enhance stroke risk factor control: A systematic review and meta-analysis

Abstract

<div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d9448472e167">Background</h5> <p id="P2">With the rapid growth worldwide in cell-phone use, Internet connectivity, and digital health technology, mobile health (mHealth) technology may offer a promising approach to bridge evidence-treatment gaps in stroke prevention. We aimed to evaluate the effectiveness of mHealth for stroke risk factor control through a systematic review and meta-analysis. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d9448472e172">Methods</h5> <p id="P3">We searched PubMed from January 1, 2000 to May 17, 2016 using the following keywords: mobile health, mHealth, short message, cellular phone, mobile phone, stroke prevention and control, diabetes mellitus, hypertension, hyperlipidemia and smoking cessation. We performed a meta-analysis of all eligible randomized control clinical trials that assessed a sustained (at least 6 months) effect of mHealth. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d9448472e177">Results</h5> <p id="P4">Of 78 articles identified, 13 met eligibility criteria (6 for glycemic control and 7 for smoking cessation) and were included for the final meta-analysis. There were no eligible studies for dyslipidemia or hypertension. mHealth resulted in greater Hemoglobin A1c reduction at 6 months (6 studies; 663 subjects; SMD: −0.44; 95% CI: [−0.82, −0.06], P=0.02; Mean difference of decrease in HbA1c: −0.39%; 95% CI: [−0.74, −0.04], P=0.03). mHealth also lead to relatively higher smoking abstinence rates at 6 months (7 studies; 9,514 subjects; OR: 1.54; 95% CI: [1.24, 1.90], P&lt;0.0001). </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d9448472e182">Conclusions</h5> <p id="P5">Our meta-analysis supports that use of mHealth improves glycemic control and smoking abstinence rates. </p> </div>